Clinical History
62 years old lady with a history of right ovarian ca. The patient is status post chemotherapy from Jul till Sep 09. Her CA 125 was 2300.2U/ml in Jul 09. PET/CT to assess disease status.
Findings
Comparison was made with the previous PET scan of 27 July 2009.
The previously noted right ovarian mass shows marked decrease in size and FDG activity (maxSUV 3.6 vs 9.2 previously).
July 2009
September 2009
Several of the previously noted FDG-avid retrocrural nodes and retroperitoneal nodes have resolved on PET. The residual retrocrural nodes of low grade activity are more in keeping with resolving nodes (maxSUV 3.1 vs 5.8 previously). The small residual non FDG-avid retrocaval nodes, paracaval nodes, aortocaval nodes, pre-aortic nodes, para-aortic nodes and right common iliac nodes are more in keeping with treated nodes.
The previously noted ascites has resolved. The previously noted FDG-avid peritoneal nodules in the right lower abdominal quadrant show marked decrease in FDG activity (maxSUV 2.8 vs 6.6 previously).
No abnormal FDG-avid focus is noted in the liver, spleen, pancreas, adrenal glands or uterus.
No FDG-avid focus or nodule is seen in the lungs. Mild scarring is present in the left lingular segment. The previously noted bilateral pleural effusions have resolved. No pericardial effusion is noted.
The previously noted FDG-avid nodes above the diaphragm have resolved on PET. The residual non FDG-avid left supradiaphragmatic nodes, precarinal node, right paratracheal nodes, right superior mediastinal nodes, left internal mammary node and left supraclavicular node are more in keeping with treated nodes. The right hilar nodes of low grade activity are more in keeping with reactive nodes.
No abnormal FDG avid focus is seen in the cerebral hemispheres or cerebellum. A mucus retention cyst is noted within the right maxillary sinus.
The bone marrow shows normal physiological distribution of FDG activity.
Clinical Impression
The previously noted right ovarian mass shows marked decrease in size and FDG activity.
Several of the previously noted FDG-avid nodal metastases above and below the diaphragm have resolved on PET. The retrocrural nodes of low grade activity show decline in FDG activity and are in keeping with resolving nodes.
The previously noted ascites and bilateral pleural effusions have resolved. The previously noted FDG-avid peritoneal metastases show marked decrease in FDG activity.
Overall findings indicate good metabolic response to treatment.
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